Medi-Cal, California’s healthcare program for children, is starting see some issues with funding, posing a huge threat to all children, especially those aged 0-5 years old. This issue is particularly pressing in California amid a major budget crisis, but it’s a concern nationwide.

In a media briefing on April 5, hosted by Ethnic Media Services, a panel of experts discussed the challenges to maintaining continuous coverage of Medi-Cal, the state’s Medicaid program for children. They also explored the national implications of reinstating annual Medicaid eligibility reviews and the potential consequences of coverage gaps for children’s health.

Speakers

  • Mayra E. Alvarez, President, The Children’s Partnership
  • Joan Alker, Executive Director, Georgetown Center for Children and Families
  • Assemblymember Tasha Boerner, 77th California Assembly District
  • Dr. Ilan Shapiro, Chief Health Correspondent and Medical Affairs Officer, AltaMed

A significant portion of children in the United States receive health coverage through Medicaid and the Children’s Health Insurance Program (CHIP). Joan Alker highlighted that federal researchers estimate that three out of four children who would lose their Medicaid during eligibility reviews would still be eligible. This statistic underscores the importance of maintaining coverage for children, especially considering that nearly half of the uninsured children nationwide could be affected by procedural issues.

Texas and Florida are among the states most affected by children losing Medicaid coverage. However, there is progress nationally in implementing policies for continuous coverage. States like Oregon, Washington, and New Mexico have obtained waivers to cover children from birth to age six, with others following suit. President Biden has also proposed extending coverage options for infants through age six and allowing three years of continuous coverage thereafter.

In California, despite previous approval of multi-year continuous Medi-Cal for children aged zero to five, funding has not been finalized due to the state’s budget deficit. Moreover, the resumption of annual redetermination of Medi-Cal eligibility has led to disenrollment of hundreds of thousands of Californians, with procedural reasons cited for the majority of cases.

Assemblymember Tasha Boerner emphasized the importance of reducing bureaucratic hurdles to ensure that families receive the necessary preventive care. While those who lose coverage for procedural reasons have 90-day retroactive coverage, the impact of coverage loss can be profound, particularly for children’s health and development.

Mayra Alvarez stressed the critical role of healthcare access in the early years of life, which are crucial for brain development. She highlighted the drop in churn rates during the pandemic when redetermination was suspended, indicating the positive impact of continuous coverage.

Dr. Ilan Shapiro emphasized the long-term consequences of gaps in healthcare coverage for children, including chronic health issues and outbreaks of preventable diseases. He underscored the responsibility of communities and policymakers to prioritize continuous coverage for the well-being of future generations.